| NPI | 1497771927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN MD0000024724) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD24724) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2018-03-17 |